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European Heart Journal. Acute Cardiovascular Care

Ezra A Amsterdam, Sandhya Venugopal
No abstract text is available yet for this article.
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
Soheila Aghlmandi, Nadine Schärer, Dik Heg, Lorenz Räber, Marcel Zwahlen, Baris Gencer, David Nanchen, David Carballo, Sebastian Carballo, Peter Jüni, Arnold von Eckardstein, Ulf Landmesser, Nicolas Rodondi, François Mach, Stephan Windecker, Christian M Matter, Thomas F Lüscher, Roland Klingenberg
BACKGROUND: Randomised controlled trials have provided conflicting results regarding procedural and clinical outcomes of thrombus aspiration combined with percutaneous coronary intervention, when compared with primary percutaneous coronary intervention alone in patients with acute coronary syndromes. METHODS: Acute coronary syndrome patients referred for coronary angiography to four Swiss university hospitals between 2009 and 2012 were enrolled in the SPUM-ACS cohort...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
Dawid L Staudacher, Vera Putz, Lukas Heger, Jochen Reinöhl, Marcus Hortmann, Steven L Zelenkofske, Richard C Becker, Christopher P Rusconi, Christoph Bode, Ingo Ahrens
BACKGROUND: Residual platelet reactivity is a predictor of poor prognosis in patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention. Thrombin is a major platelet activator and upon initiation of the coagulation cascade, it is subsequently produced downstream of factor IXa, which itself is known to be increased in ACS. Pegnivacogin is a novel RNA-aptamer based factor IXa inhibitor featuring a reversal agent, anivamersen. We hypothesized that pegnivacogin could reduce platelet reactivity...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
Anu Kataja, Tuukka Tarvasmäki, Johan Lassus, Lars Køber, Alessandro Sionis, Jindrich Spinar, John Parissis, Valentina Carubelli, Jose Cardoso, Marek Banaszewski, Rossella Marino, Markku S Nieminen, Alexandre Mebazaa, Veli-Pekka Harjola
BACKGROUND: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. METHODS: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
Vince C de Hoog, Swee Han Lim, Ingrid Em Bank, Crystel M Gijsberts, Irwani B Ibrahim, Win Sen Kuan, Shirley Bs Ooi, Terrance Sj Chua, E Shyong Tai, Fei Gao, Gerard Pasterkamp, Hester M den Ruijter, Pieter A Doevendans, Thierry X Wildbergh, Arend Mosterd, A Mark Richards, Dominique Pv de Kleijn, Leo Timmers
BACKGROUND: The HEART score is a simple and effective tool to predict short-term major adverse cardiovascular events in patients suspected of acute coronary syndrome. Patients are assigned to three risk categories using History, ECG, Age, Risk factors and Troponin (HEART). The purpose is early rule out and discharge is considered safe for patients in the low risk category. Its performance in patients of Asian ethnicity is unknown. We evaluated the performance of the HEART score in patients of Caucasian, Chinese, Indian and Malay ethnicity...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Akiomi Yoshihisa, Takamasa Sato, Katsuya Kajimoto, Naoki Sato, Yasuchika Takeishi
BACKGROUND: Although the obesity paradox may vary depending upon clinical background factors such as age, gender, aetiology of heart failure and comorbidities, the reasons underlying the heterogeneous impact of body mass index (BMI) on in-hospital cardiac mortality under various conditions in patients with acute heart failure syndromes (AHFSs) remain unclear. METHODS: Among 4617 hospitalised patients with AHFSs enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, the patient characteristics and in-hospital cardiac mortality rates in those with low BMI (BMI <25 kg/m(2), n = 3263) were compared to those with high BMI (BMI ⩾25 kg/m(2), n = 1354)...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Alexander Jobs, Ronja Simon, Suzanne de Waha, Kyrill Rogacev, Alexander Katalinic, Valentin Babaev, Holger Thiele
BACKGROUND: The prognostic impact of pneumonia and signs of systemic inflammation in patients with acute decompensated heart failure (ADHF) has not been fully elucidated yet. The aim of the present study was thus to investigate the association of pneumonia and the inflammation surrogate C-reactive protein with all-cause mortality in patients admitted for ADHF. METHODS: We analysed data of 1939 patients admitted for ADHF. Patients were dichotomised according to the presence or absence of pneumonia...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Guido Tavazzi, Mary White, Susanna Price
We describe a case of a young woman requiring veno-venous extracorporeal support for severe secondary respiratory failure who developed a myocardial ischaemia due to an intermittent obstruction of the right coronary sinus by a fluttering thrombus. She was medically treated with full anticoagulation regimen, needed for the veno-venous extracorporeal membrane oxygenation support, without any other ischaemic or embolic event.
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Nigel S Tan, Bradley Sarak, Keith Aa Fox, David Brieger, Ph Gabriel Steg, Chris P Gale, Deepak L Bhatt, Frederick A Spencer, Francois R Grondin, Shaun G Goodman, Andrew T Yan
BACKGROUND: Pulse pressure is a readily available vital sign that has been shown to independently predict outcomes in several cardiovascular disease states. We investigated the prognostic significance of pulse pressure (PP) and systolic blood pressure (SBP) among patients with acute coronary syndromes (ACS). METHODS: A total of 14,514 patients with ACS in the prospective, multicentre Global Registry of Acute Coronary Events (GRACE), expanded GRACE (GRACE-2) and Canadian Registry of Acute Coronary Events (CANRACE) were stratified by initial PP on presentation...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Kirian van der Weg, Wichert J Kuijt, Sebastiaan Cam Bekkers, Jan Gp Tijssen, Cynthia L Green, Miguel E Lemmert, Mitchell W Krucoff, Anton Pm Gorgels
AIMS: Ventricular arrhythmia (VA) bursts following recanalisation in acute ST-elevation myocardial infarction (STEMI) are related to larger infarct size (IS). Inadequate microvascular reperfusion, as determined by microvascular obstruction (MVO) using cardiac magnetic resonance imaging (CMR), is also known to be associated with larger IS. This study aimed to test the hypothesis that VA bursts identify larger infarct size in spite of optimal microvascular reperfusion. METHODS: All 65 STEMI patients from the Maastricht ST elevation (MAST) study with brisk epicardial flow (TIMI 3), complete ST recovery post-percutaneous coronary intervention and early CMR were included...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
María Dolores Pola-Gallego-de-Guzmán, Manuel Ruiz-Bailén, Maria-Angeles Martínez-Arcos, Artur Gómez-Blizniak, Ana-Maria Castillo Rivera, Jesus Cobo Molinos
BACKGROUND: Patients with acute coronary syndrome complicated with high degree atrioventricular block still have a high mortality. A low percentage of these patients need a permanent pacemaker (PPM) but mortality and associated factors with the PPM implant in acute coronary syndrome patients are not known. We assess whether PPM implant is an independent variable in the mortality of acute coronary syndrome patients. Also, we explored the variables that remain independently associated with PPM implantation...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Andreas Mitsis, Evi Christodoulou, Panayiota Georgiou
Kounis syndrome is defined as the coincidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergic event. The three reported variants of Kounis syndrome are vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus. The syndrome is caused by various inflammatory mediators. The pathophysiological characteristics of Kounis syndrome involve coronary artery spasm and/or atheromatous plaque erosion or rupture during an allergic reaction...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
Marc J Claeys, Ingo Ahrens, Peter Sinnaeve, Roberto Diletti, Roberta Rossini, Patrick Goldstein, Kasia Czerwińska, Héctor Bueno, Maddalena Lettino, Thomas Münzel, Uwe Zeymer
Chest pain units are defined as organizational short stay units with specific management protocols designed to facilitate and optimize the diagnosis of patients presenting with chest pain in the emergency department. The present document is intended to standardize and facilitate the installation of chest pain units nearby to the emergency department or as an integral part of the emergency department. Recommendations on organizational structure, physical and technical requirements and on disease management are presented...
April 2017: European Heart Journal. Acute Cardiovascular Care
Christian Mueller, Evangelos Giannitsis, Martin Möckel, Kurt Huber, Johannes Mair, Mario Plebani, Kristian Thygesen, Allan S Jaffe, Bertil Lindahl
No abstract text is available yet for this article.
April 2017: European Heart Journal. Acute Cardiovascular Care
Yuki Kotani, Mamoru Toyofuku, Takashi Tamura, Kotaro Shimada, Yushi Matsuura, Hiroyuki Tawa, Munehiro Uchikawa, Sonoko Higashi, Jumpei Fujimoto, Kaoru Yagita, Fumitaka Sato, Yuichiro Atagi, Toshiaki Hamasaki, Toshihide Tsujimoto, Takao Chishiro
OBJECTIVE: The objective of this study was to evaluate the validity of D-dimer measurements for the diagnosis of acute aortic syndrome in patients admitted to hospital with acute chest pain. METHODS: A retrospective observational study design was used. Consecutive patients ( n=887) admitted to a tertiary hospital with acute chest pain (acute aortic syndrome, 123; acute pulmonary embolism, 29; and other disease, 735) from the emergency department between January 2011 and April 2014 were assessed to validate the diagnostic value of D-dimer measurements...
April 2017: European Heart Journal. Acute Cardiovascular Care
Martin Möckel, Evangelos Giannitsis, Christian Mueller, Kurt Huber, Allan S Jaffe, Johannes Mair, Mario Plebani, Kristian Thygesen, Bertil Lindahl
No abstract text is available yet for this article.
April 2017: European Heart Journal. Acute Cardiovascular Care
Charan Yerasi, Edward Koifman, Gaby Weissman, Zuyue Wang, Rebecca Torguson, Jiaxiang Gai, Joseph Lindsay, Lowell F Satler, Augusto D Pichard, Ron Waksman, Itsik Ben-Dor
BACKGROUND: Takotsubo syndrome is also known as stress cardiomyopathy because of the regularity with which it has been associated with physical or emotional stress. Such stress may well be a "trigger" of the syndrome. AIMS: This analysis was undertaken to describe our experience with this disorder and in particular to examine the effects of the underlying trigger on outcomes. METHODS: We conducted a retrospective review of the medical records of 345 consecutive patients treated at our institution from 2006 to 2014...
April 2017: European Heart Journal. Acute Cardiovascular Care
Bernhard Jäger, Serdar Farhan, Miklos Rohla, Günter Christ, Andrea Podczeck-Schweighofer, Wolfgang Schreiber, Anton N Laggner, Franz Weidinger, Thomas Stefenelli, Georg Delle-Karth, Alfred Kaff, Gerald Maurer, Kurt Huber
BACKGROUND: While contributors to system delay in ST-elevation myocardial infarction (STEMI) are well described, predictors of patient-related delays are less clear. The aim of this study was to identify predictors that cause delayed diagnosis of STEMI in a metropolitan system of care (VIENNA STEMI network) and to investigate a possible association with long-term mortality. METHODS: The study population investigated consisted of 2366 patients treated for acute STEMI in the Vienna STEMI registry from 2003-2009...
April 2017: European Heart Journal. Acute Cardiovascular Care
Claudio Moretti, Javaid Iqbal, Scott Murray, Maurizio Bertaina, Yasir Parviz, Stephen Fenning, Giorgio Quadri, Julian Gunn, Fabrizio D'Ascenzo, Sebastiano Marra, Corrado Moiraghi, Franco Riccardini, Franco Veglio, Fiorenzo Gaita, Martin Denvir
BACKGROUND: Identifying patients with acute coronary syndrome (ACS) who are approaching the end of life and who may not benefit from an aggressive interventional approach is important but clinically challenging. The Gold Standards Framework (GSF) prognostic guide was developed using multidimensional criteria to identify cancer patients who could benefit from end-of-life care. We assessed the utility of the GSF to predict one-year mortality in ACS patients. METHODS: ACS patients admitted between May 2012 and July 2013 at the three participating cardiac centres in Europe were enrolled...
April 2017: European Heart Journal. Acute Cardiovascular Care
Jing Li, Xi Li, Joseph S Ross, Qing Wang, Yongfei Wang, Nihar R Desai, Xiao Xu, Sudhakar V Nuti, Frederick A Masoudi, John A Spertus, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Fibrinolytic therapy is the primary reperfusion strategy for ST-segment elevation myocardial infarction in China, and yet little is known about the quality of care regarding its use and whether it has changed over time. This issue is particularly important in hospitals without the capacity for cardiovascular intervention. METHODS: Using a sequential cross-sectional study with two-stage random sampling in 2001, 2006, and 2011, we characterised the use, timing, type and dose of fibrinolytic therapy in a nationally representative sample of patients with ST-segment elevation myocardial infarction admitted to hospitals without the ability to perform percutaneous coronary intervention...
April 2017: European Heart Journal. Acute Cardiovascular Care
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